Equine Ch 15 Misc Flashcards
What is the most common inflammatory nodular skin disease of the horse?
Eosinophilic granuloma
Where do lesions most commonly occur in eosinophilic granuloma?
Saddle region
What is a classic histopathologic feature of the eosinophilic granuloma?
Collagen flame figures
T/F Eosinophilic granulomas are typically non painful and nonpruritic.
True
What are the histopathologic findings of eosinophilic granuloma?
Multifocal areas of collagen flame figures. Small foci of eosinophilic folliculitis and furunculosis.
Lymphoid nodules may be prominent. Older lesions exhibit marked dystrophic mineralization and may be misdiagnosed as calcinosis circumscripta or mast cell tumors
What are the histopathologic findings of eosinophilic granuloma?
Multifocal areas of collagen flame figures. Small foci of eosinophilic folliculitis and furunculosis.
Lymphoid nodules may be prominent. Older lesions exhibit marked dystrophic mineralization and may be misdiagnosed as calcinosis circumscripta or mast cell tumors
What are some treatment options for eosinophilic granuloma?
Benign neglect - may resolve on their own
Surgical excision of solitary lesions
Sublesional injections of steroids q2 weeks
Systemic steroids for multiple lesions
Treatment of concurrent insect-bite hypersensitivity, atopy or food allergy
Which condition is characterized by multiple asymptomatic papules on only one side of the body?
Unilateral papular dermatosis
How is unilateral papular dermatosis treated?
Usually benign neglect. Undergoes spontaneous resolution and papules are typically nonpainful/nonpruritic.
Steroids cause rapid resolution.
What condition is characterized by three or fewer nodules, 1-10cm in diameter, typically present in the girth area behind the elbow?
Axillary nodular necrosis, aka focal nodular eosinophilic granuloma and arteritis
Describe the clinical signs seen in sterile eosinophilic folliculitis and furunculosis
Multiple tufted papules that become crusted and alopecic are symmetric and may be present anywhere on the body, although neck, shoulder, brisket and dorsolateral thorax most common.
Pruritus usually moderate to marked, occasionally mild.
What histopathologic findings would you expect to see with eosinophilic folliculitis and furunculosis?
Infiltrative-to-necrotizing eosinophilic mural folliculitis and furunculosis and occasionally, focal collagen flame figures. Focal areas of eosinophilic mural folliculitis, luminal folliculitis and furunculosis may be seen in biopsy specimens from horses with insect-bite hypersensitivity, atopic dermatitis, and food allergy in the corresponding clinical lesions (tufted papules)
What is the treatment for eosinophilic folliculitis and furunculosis?
Systemic steroids. Relapses common. Long term management best achieved by appropriate control of allergy.
How is multi systemic eosinophilic epitheliotropic disease characterized?
Exfoliative dermatitis, ulcerative stomatitis, wasting and infiltration of epithelial tissues by eosinophils, lymphocytes and macrophages.
Which breed has been reported in 70% of cases of multi systemic eosinophilic epitheliotropic disease
Standardbreds.
Thoroughbreds account for about 20% of all reported cases.
What systemic signs can be seen with multi systemic eosinophilic epitheliotropic disease?
Progressive weight loss, variable appetite (poor, normal, ravenous), pitting edema of ventral chest, abdomen, and distal limbs. Fever or recalcitrant diarrhea in up to 50% of cases.
What are some differential diagnosis for multi systemic eosinophilic epitheliotropic disease?
PF, SLE, sarcoidosis, BP, PV, vasculitis, EM, epitheliotropic lymphoma, cutaneous adverse drug reaction, and various toxicosis (vetch, stachybotryotoxicosis)
Describe the histopathologic findings in multi systemic eosinophilic epitheliotropic disease.
Intermingling of inflammatory reaction patterns: superficial and deep perivascular, lichenoid interface, interstitial, diffuse, and granulomatous. Eosinophils, lymphocytes and plasma cells are the dominant inflammatory cells.
Epidermal hyperplasia is marked and irregular. Hyperkeratosis is prominent and mixed (orthokeratotic and parakeratotic). Epitheliotropic infiltration of eosinophils and lymphocytes is typical, and apoptotic keratinocytes may be prominent. Eosinophilic folliculitis and furunculosis may be seen. Neutrophilic microabcesses and suppurative folliculitis and furunculosis.
What is the prognosis for multi systemic eosinophilic epitheliotropic disease?
Varies. Most horses suffer a progressive dermatitis and wasting over the course of several months (1-10) and are eventually euthanized or die.
May respond to steroids early in the course of disease, however horses usually do not respond.
Which breed of horse is predisposed to linear alopecia?
Quarter horses